兔眼内窥镜下睫状体光凝联合白内障超声乳化手术对房水成分的影响  

Effects of endoscopic cyclophotocoagulation with phacoemulsification on composition levels in aqueous humor of rabbits

作　　者：张运江 俞方良[2] 刘淼[2] 金洪尧 黄国富[2] 

机构地区：[1]江西省吉安康明眼科医院,江西省吉安市343000 [2]南昌大学第三附属医院眼科(南昌眼科医院),江西省南昌市330008

出　　处：《眼科新进展》2014年第10期918-922,共5页Recent Advances in Ophthalmology

基　　金：江西省自然科学基金资助(编号:20121511010015)~~

摘　　要：目的观察眼内窥镜下睫状体光凝术(endoscopic cyclophotocoagulation,ECP)联合白内障超声乳化及人工晶状体植入术(phacoemulsification and intraocular lens,Phaco+IOL)后不同范围睫状体光凝对前房蛋白质浓度、TNF-α含量、IL-1β含量改变的影响,并分析对前房炎症反应的影响。方法将24只(48眼)成功建立慢性青光眼模型的灰兔随机分成A组、B组、C组、D组,其中A组、B组、C组分别给予180°、270°、360°三种不同范围睫状体光凝的ECP+Phaco+IOL手术,D组给予小梁切除(trabeculectomy,TRAB)+Phaco+IOL手术,分别对术前、术后房水蛋白质浓度、TNF-α、IL-1β含量检测;观察术后炎症反应;术中、术后并发症的发生情况。结果 A组、B组、C组、D组术后1 d、7 d、14 d房水中蛋白质浓度、TNF-α含量、IL-1β含量升高,30 d基本恢复至术前水平;术前及术后1 d、7 d、14 d、30 d房水中蛋白质浓度、TNF-α含量、IL-1β含量:不同组间含量随时间变化趋势相同,差异均无统计学意义(P=0.153、0.593、0.203);相同时间点不同组间含量差异均无统计学意义(均为P>0.05)。4组术后蛋白质浓度与前房炎症反应均呈正相关(均为P<0.05)。结论 ECP+Phaco+IOL与TRAB+Phaco+IOL两种不同联合手术方式术后早期均引起蛋白质浓度、TNF-α和IL-1β含量升高,30 d基本恢复正常;而在同一时间点不同的手术方式对蛋白质浓度、TNF-α和IL-1β含量影响不大。Objective To observe the effects of endoscopic cyclophotocoagula- tion with phacoemulsification and intraocular lens implantation on protein, TNF-α ; IL- 1β contents in aqueous humor, and analyze its effects on inflammation in anterior chamber. Methods Twenty-four gray rabbit （48 eyes） were successfully established chronic glaucoma and randomly divided into group A, B, C, D. Group A, B, C were given three different ranges of endoscopic cyclophotocoagulation （180°、270°、360°） with phacoemulsification and intraocular lens implantation. Group D was treated with trabeculectomy with phacoemulsification and intraocular lens implantation. The preoperative and postoperative protein,TNF-α , IL- 1β levels in aqueous humor were detected,the postoperative inflammation reaction in anterior chamber was observed, and the incidence of complication was also observed. Results The protein concentration,TNF-α levels,IL- 1β levels in aqueous humor at postoperative 1 day, 7 days, 14 days in group A, B, C, D were all increased, reached the preoperative level at postoperative 30 days. The difference was not statistically significant between groups of different levels similar trend changes over time （P = 0. 153,0.593,0.203 ） ;The difference was not statistically significant at same time point between different groups （ all P 〉 0.05 ）. Levels of protein were correlated to the grades of anterior chamber inflammation reaction in four groups （ all P 〈 0.05）. Conclusion Endoscopic cyclophotocoagulation with phacoemulsification and intraocular lens implantation, and trabeculectomy with Phacoemtflsification and intraocular lens implantation can all increase the levels of protein,TNF-α and IL- 1β at the postoperative early stage, and nearly returned to normal at postoperative 30 days. But at the same time point, the surgical methods have little effects on levels of protein, TNF-α and IL- 1β.

关 键 词：内窥镜 睫状体光凝 小梁切除术 白内障超声乳化吸除术 房水 蛋白质 肿瘤坏死因子-α 白细胞介素-1β 

分 类 号：R779.66[医药卫生—眼科]